Provider Demographics
NPI:1629540257
Name:SANFORD, RHONDA JEAN (LCSW)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:JEAN
Last Name:SANFORD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:JEAN
Other - Last Name:WATSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:COATESVILLE VAMC, ATTN: RHONDA SANFORD, LCSW,
Mailing Address - Street 2:1400 BLACKHORSE HILL RD, BLDG 57, RM 227
Mailing Address - City:COATESVILLLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320
Mailing Address - Country:US
Mailing Address - Phone:610-384-7711
Mailing Address - Fax:610-383-0264
Practice Address - Street 1:COATESVILLE VAMC, ATTN: RHONDA SANFORD, LCSW,
Practice Address - Street 2:1400 BLACKHORSE HILL RD, BLDG 57, RM 227
Practice Address - City:COATESVILLLE
Practice Address - State:PA
Practice Address - Zip Code:19320
Practice Address - Country:US
Practice Address - Phone:610-384-7711
Practice Address - Fax:610-383-0264
Is Sole Proprietor?:No
Enumeration Date:2018-12-20
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0166861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical